Dreading Your Mammogram? Here’s What Can Help

Margarita Zuley, MD, FACR, chief of breast imaging and professor and vice chair of quality and strategic development for the University of Pittsburgh Medical Center department of radiology. A diagnostic radiologist specializing in breast imaging, she has been the principal investigator on multiple grants related to digital and 3-D mammography.

Published Date: August 1, 2017

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Not looking forward to your next mammogram? You’re not alone. Many women experience anxiety in the days leading up to it.

But mammograms do save lives. These X-rays help identify breast cancer in women with no signs or symptoms of the disease.

THE DISCOMFORT FACTOR

When researchers have studied mammogram pain or discomfort, their findings have varied wildly—based on numerous studies, anywhere from 1% to 77% of women report that the test was painful.

Meanwhile, an important study conducted at Beth Israel Deaconess Medical Center found that most women don’t experience any pain or anxiety at all. Discomfort…perhaps. But pain is not a given—and quite subjective at that. Afterward, most women said the exam wasn’t nearly as awful as they’d feared.

SIMPLE STEPS THAT HELP

Besides understanding that mammograms are often not nearly as uncomfortable or painful as many women fear, there are some simple things you can do to reduce pre-mammogram anxiety and to make the experience itself less unpleasant. For example…

• Limit caffeine intake. Caffeine can make your breasts more tender. Try decreasing your intake starting a few days before the exam.Don’t eliminate caffeine, though, or you’ll risk having a caffeine-withdrawal headache.

• Try Tylenol. Most women can safely use acetaminophen (Tylenol), taken at a standard dose within four hours of the exam, to minimize discomfort. Bonus: It will reduce any soreness you might experience afterward. Avoid aspirin and other nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Motrin, Advil), which can increase the risk for bruising.

• Exercise before the test. A study conducted by researchers at Barretos Cancer Hospital in São Paulo State, Brazil, found that women who exercised for 20 minutes just prior to their mammograms reported less pain after screening compared with women who didn’t exercise—perhaps because the physical activity promoted the release of endorphins, hormones that have a pain-relieving effect. Exercises included warm-ups and stretching…then a series of 10 upper-body moves, such as arm and shoulder circles or interlocking the fingers behind the back and raising the arms.

• Know what to expect. Women who feel armed with information about the procedure experience less pain and discomfort from mammograms—likely because they feel less anxiety.

What helps: For first-timers, ask your doctor to walk you through the procedure when he/she prescribes your mammogram. A few days prior to the test, do a dry run to the facility so you know exactly how to get there and, if you’re driving, where to find parking.

If possible, bring a friend or family member with you to your appointment for support. The less you have to worry about the day of your mammogram, the more relaxed—and therefore the less pain—you will feel.

WHAT WORSENS DISCOMFORT

Most women know that mammograms tend to be less uncomfortable during the first two weeks of the menstrual cycle when the breasts aren’t as sensitive. Mammograms are also more accurate when performed on that schedule. This is likely because breast tissue is generally less dense at that time and more easily imaged.

What many women don’t know: Certain health conditions can increase pain or discomfort during a mammogram. What helps women affected by…

• Chronic pain. When scheduling, alert the facility that you have chronic pain. There may be a technologist on staff who is trained in working with chronic pain patients. Continue taking any prescription medications as normal, and be sure to try the general tips above. Never be afraid to speak up if something hurts too much! The compression used for mammograms is based in part on the patient’s tolerance.

• Cold temperatures. If you have trouble tolerating cold temperatures, ask the technologist for a robe or bring one from home. If your hands get cold, you can ask to wear surgical gloves.

• Dense breasts. Roughly 25% of postmenopausal women have dense breasts. This simply means that their breasts have denser, lumpier tissue. Dense breasts tend to be more sensitive to pain and are likely to benefit from a reduction in caffeine intake as described earlier.

• A lumpectomy. If you have had this procedure, which involves surgical removal of a suspected cancerous tumor and surrounding tissue, you should return to annual mammogram imaging after surgery.

Radiation and surgery can both cause changes in the breast tissue and skin that may make a mammogram less comfortable. The scar itself may be tender, and the skin may be more sensitive to the touch. Let your mammogram technologist know so that he/she can take any necessary precautions, such as making adjustments in position and compression.

• Weight issues. Obese women are nearly twice as likely to cite pain as a mammogram deterrent as nonobese women. The exact reasons are unknown, but being overweight has been associated with a lower pain threshold. Some obese patients also feel that having larger breasts or breast tissue that extends under the arms renders mammograms more painful. Be sure to try the general tips above.

DON’T LET A DISABILITY STOP YOU

Use of a wheelchair or scooter should not prevent you from getting screened for breast cancer.

What helps: When scheduling a mammogram, let the facility where you’ll be tested know if you will need assistance undressing…standing…moving your arms…and/or transferring from your wheelchair or scooter. The technologist will work one-on-one with you to make the exam as comfortable as possible.

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